PGHN Services in Scotland Michael Bisset for SPGHANG

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PGHN Services in ScotlandMichael Bisset for
SPGHANG

• Regional planning experience
• North of Scotland
• National planning

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Regional PGHN Services
North 1.2 million (24) 61 of area
East 1.4 million (27) 10 of area
West 2.5 million (49) 29 of area
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North of Scotland

• Acute services review (1998)
• Meeting of Consultant Staff (1999)
• Local drivers
• Need for critical mass for services
• Need for critical mass for training
• Two Health Boards actively wanting to work
  together
• Formation of Regional Planning (Paed.) Group 2002
• HDL (2004) 46, Empowering Regional Planning
• Delivering for Health Nov 2005

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Staffing
Paediatric Gastroenterologist 1
Paediatric Gastroenterologist 2
Dundee
Inverness
Aberdeen
Consultant with an interest Paediatric
Dietitians GI nurse
Consultant with an interest Paediatric Dietitians
Paediatric Dietitians Nutrition nurse
9 General Paediatricians 4 Paediatric Surgeons
5 General Paediatricians p/t Paediatric Surgeon
8 General Paediatricians p/t Paediatric Surgeon
Outreach (Peripheral Clinics, Community Nurses,
CCH,)
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Patient Pathway (L.L.)
Inverness Initial referral specialist review
Skye Home Peripheral clinic
Aberdeen Diagnosis initial treatment
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Remaining Issues

• No additional funding to create Network
• MCNs are not cost neutral
• Attempts to fund Network Manager unsuccessful
• No additional AHP and Nursing posts created
• IT infrastructure not well integrated
• No financial incentives for smaller HB to fund
  MCNs

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National

• Scottish PGHN group started meeting (circa 1999)
• Health Minister sets up Child Health Support
  Group (2002)
• HDL (2002) 69, Promoting development of MCNs
• First NHS Paediatric GI appointment in Glasgow
  (West)
• No regional planning activity in Edinburgh (East)
• Formation of Paediatric Regional Planning group
  (North)
• HDL (2003) 43, Review of Specialist Paediatric
  Services
• New Consultant contract (2004)
• Review of PGHN services. National meeting (2004)

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Paediatric Gastroenterology, Hepatology and
Nutrition Services in Scotland A report
commissioned by the Child Health Support Group,
Scottish Executive as part of their Review of
Specialist Paediatric Services, May
2004http//www.bspghan.org.uk/document/regional/
ScottishGI.PDF
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Scottish Specialist PGHN Services
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Paediatric Gastroenterology, Hepatology and
Nutrition Services in Scotland Proposed Service
Model

• Develop
• National PGHN service for Scotland with the
  proper staffing and resourcing of each of the
  three regional services
• Outreach to cover all of Scotlands children with
  support for the clinical workload of DGHs and the
  promotion of the Consultant with an interest
  role. Staff in Dietetics and Nursing are
  essential to this development.
• 24/7 telephone advice service for consultant with
  a national telephone on call service

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Paediatric Gastroenterology, Hepatology and
Nutrition Services in ScotlandWhat progress
have we made ?

• National Grid training programme
• Teaching programme via video conferencing
• Research network (Wellcome Trust for 682,723)
• Working on Treatment Guidelines and National on
  call
• SPGHANG meet 3 or 4 times per year (1
  residential)
• Staffing

Locum Post in Edinburgh has been
advertised Funding for new consultant in Glasgow
agreed
Hope to have three fully functional Regional
Networks within a National Service in the next 2
to 3 years